Broadway Dental Wellness PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

BROADWAY DENTAL WELLNESS PLLC

Doing business as

Broadway Dental

Practice address

1510 N Broadway St
Hastings, MI 49058-3024

Phone

(269) 945-3358

NPI assigned

May 22, 2023

Last updated

May 22, 2023By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Andres Setaputri, DDSNPI 1710393095

Title

Owner

Phone

(734) 250-1473

Specialties & licenses 1

Addresses

Other names 1

• Broadway Dental Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Andres Wilson Setaputri, DDS

  • General Practice Dentistry
  • Southgate, MI
  • NPI 1710393095
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1684713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684713600000",
    "number": "1477245371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1510 N BROADWAY ST",
            "city": "HASTINGS",
            "state": "MI",
            "postal_code": "490583024",
            "telephone_number": "269-945-3358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 N BROADWAY ST",
            "city": "HASTINGS",
            "state": "MI",
            "postal_code": "490583024",
            "telephone_number": "269-945-3358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROADWAY DENTAL WELLNESS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-22",
        "last_updated": "2023-05-22",
        "certification_date": "2023-05-21",
        "status": "A",
        "authorized_official_last_name": "SETAPUTRI",
        "authorized_official_first_name": "ANDRES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "734-250-1473",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Broadway Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Scott B Brasseur, M.D.
• Brigit Kerry Brennan, MD
• Belicia Simone Bridges
• Kaylan Briggs
• Bright Start Pediatrics, P.C.
• Franklin Brown, PHARMD
• Dennis Alan Bruce, M.D.
• Regan Marie Bunker, PA-C
• Jordan Burke
• Maggie Marie Burmania

• General Practice Dentistry in Hastings, MI
• Providers in Hastings, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.